The Israel Medical Association journal : IMAJ · 2026
Is Transcatheter Aortic Valve Implantation Still Effective in Nonagenarians?
СтатьяНазвание и аннотация: Перевод в очереди
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Ayzenberg Oded, Shlezinger Tomer, Orvieto Noam, Katzir Itzhak, Bloch Sigalit, Landsberger Daniel, Sigal Naomi, Rotman Eran, Vered Zvi
Аннотация
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the preferred therapeutic method for elderly patients presenting with severe symptomatic aortic stenosis (AS). Most TAVI procedures are performed in patients between 75-85 years of age. A few publications exist on TAVI in patients over 90 years, yet the outcome and complication rates are inconsistent.
OBJECTIVES: To identify all patients with AS who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of the TAVI.
METHODS: We reviewed the Maccabi Healthcare Services database for all severe/critical AS patients who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of TAVI. These patients were compared to all patients aged 80-89 years who underwent TAVI during the same time. Follow-up ended on 31 December 2022. We compared mortality and complications rates in nonagenarians vs. those 80-89 years and evaluated the change in left ventricular ejection fraction before and after the procedure.
RESULTS: We identified 36 nonagenarians who underwent TAVI during the study period, mean age 92.3 years, male:female ratio 15:21. During a mean follow-up period of 3 years, 44% of nonagenarians died, 26% of the control patients died (P < 0.01).
CONCLUSIONS: TAVI in nonagenarians is feasible. Total mortality during follow-up was significantly higher in nonagenarians. Overall complication rates were also higher in nonagenarians, mostly due to vascular complications. Left ventricular dysfunction appeared to improve after TAVI, even in nonagenarians.
OBJECTIVES: To identify all patients with AS who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of the TAVI.
METHODS: We reviewed the Maccabi Healthcare Services database for all severe/critical AS patients who underwent TAVI between 2019 and 2020, specifically those age > 90 years at the time of TAVI. These patients were compared to all patients aged 80-89 years who underwent TAVI during the same time. Follow-up ended on 31 December 2022. We compared mortality and complications rates in nonagenarians vs. those 80-89 years and evaluated the change in left ventricular ejection fraction before and after the procedure.
RESULTS: We identified 36 nonagenarians who underwent TAVI during the study period, mean age 92.3 years, male:female ratio 15:21. During a mean follow-up period of 3 years, 44% of nonagenarians died, 26% of the control patients died (P < 0.01).
CONCLUSIONS: TAVI in nonagenarians is feasible. Total mortality during follow-up was significantly higher in nonagenarians. Overall complication rates were also higher in nonagenarians, mostly due to vascular complications. Left ventricular dysfunction appeared to improve after TAVI, even in nonagenarians.